Real-world evaluation of the transition between originator and follow-on glatiramer acetate in people with multiple sclerosis: the “GA transition” study
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND OBJECTIVE: The introduction of follow-on formulations of glatiramer acetate (GA) has raised questions regarding their equivalence to the originator in real-world practice. This study aimed to evaluate the clinical effectiveness and safety of switching from originator GA to its follow-on product, Copemyl® (CO), in people with multiple sclerosis (MS). METHODS: A multicenter, retrospective observational study was conducted, including patients with MS treated for at least two years with GA followed by at least two years with CO. The primary outcome was the annualized relapse rate (ARR), whereas secondary outcomes included disability progression assessed by the Expanded Disability Status Scale (EDSS), MRI activity, and adverse events (AEs). RESULTS: A total of 138 patients were included. The ARR was very low and comparable across treatments (GA: 0.028; CO: 0.019), with a mean paired difference of -0.009 (95 % CI -0.028 to 0.010; p = 0.38), falling within the predefined equivalence margin. Disability progression over six months occurred in 6.0 % of GA and 7.3 % of CO periods (HR 1.53; 95 % CI 0.74-3.16; p = 0.26). No significant difference was found in MRI activity (52.2 % vs 60.1 %, p = 0.14). Safety profiles were comparable, with mostly mild to moderate AEs; four serious AEs occurred under CO, two of them possibly treatment-related. CONCLUSIONS: Switching from originator GA to CO did not influence clinical outcomes or safety. These findings support the therapeutic equivalence of the two formulations in real-world clinical practice, by supporting previous evidence from randomized trials.
Authors: Irene Schiavetti, Pietro Annovazzi, Cinzia Cordioli, Mattia Pozzato, Sarah Rasia, Elisabetta Signoriello, Giacomo Lus, Livia Pasquali, Beatrice Giovannini, Alice Laroni, Alessio Carbone, Paola Cavalla, Sara La Gioia, Valentina Torri Clerici, Chiara Zecca, Francesca Caleri, Alessia Di Sapio, Maria Pia Sormani
Institutions: IRCCS Azienda Ospedaliera Metropolitana, University of Genoa, Azienda Socio Sanitaria Territoriale della Valle Olona, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Campania "Luigi Vanvitelli", University of Pisa, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Ospedale Papa Giovanni XXIII, Fondazione IRCCS Istituto Neurologico Carlo Besta, Università della Svizzera italiana, Krankenhaus Meran, Ospedale San Luigi Gonzaga
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,500
OpenAlex ID: W7130882827
